Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We present three cases of children with acute neurologic changes while undergoing induction chemotherapy for acute lymphoblastic leukemia (ALL). These cases fall into the spectrum of reversible posterior leukoencephalopathy syndrome (RPLS), including abrupt alterations in mental status, headache, seizures, visual changes, hypertension, and characteristic findings on magnetic resonance imaging. Although the underlying mechanism of RPLS is still under investigation, the appropriate treatment and management of the acute event is becoming clearer. Early treatment of hypertension, control of seizure activity, and withdrawal of inciting agents can lead to rapid reversal of symptoms and return to baseline functioning.
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PMID:Reversible posterior leukoencephalopathy syndrome in children undergoing induction therapy for acute lymphoblastic leukemia. 1612 92

Two cases of spinal epidural hematoma and two cases of intracranial subdural hematoma after lumbar puncture (LP) are reported in children receiving chemotherapy for acute lymphoblastic leukemia and non-Hodgkin lymphoma. The bleeding was asymptomatic but interfered with treatment in one case, and caused either severe backache or headache but no neurological deficit in the other three patients. The platelet counts were 8 and 46 x 10(9)/L in two patients and were normal in the other patients at the time of LP. All recovered without surgical treatment. There is an inherent, albeit uncommon, risk of bleeding into the central nervous system associated with LP in children with cancer and should be distinguished from postdural puncture headache (PDPH). Thrombocytopenia is not always an accompanying factor.
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PMID:Intraspinal and intracranial hemorrhage after lumbar puncture. 1615 28

Somnolence syndrome classically occurs in children after cranial irradiation for acute lymphocytic leukemia. Symptoms include somnolence, fever, nausea and vomiting, and headache. The authors report a 29 year-old female who developed symptoms compatible with the somnolence syndrome after completing radiation therapy for a benign meningioma near the pineal region. Five weeks after completing conformal radiation therapy (54 Gy), she developed profound fatigue, headaches, and 102-degree fevers. Physical examination and routine laboratory work were unrevealing. Imaging was not performed. Prednisone was prescribed and within 1 week her symptoms had largely resolved. This is the first report of the somnolence syndrome after focal radiation therapy. The possible etiology of the somnolence syndrome is discussed.
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PMID:Somnolence syndrome after focal radiation therapy to the pineal region: case report and review of the literature. 1657 37

Intracranial granulocytic sarcoma (chloroma) may occur rarely in leukemia. A 27-year-old male presented with an isolated recurrence of granulocytic sarcoma manifesting as an intraaxial mass 27 months after complete remission of acute lymphoblastic leukemia. He was admitted due to a severe headache and blurred vision. Brain magnetic resonance imaging demonstrated an enhanced mass which was initially interpreted as an extraaxial tumor in the right temporal region. Because of increased intracranial pressure and the mass effect, open biopsy with surgical resection was performed. The biopsy result indicated that intraaxial lymphoblastic leukemia infiltration had caused CNS relapse. Although granulocytic sarcoma occurs primarily in patients with acute myelogenous leukemia, the authors report a rare case of intraparenchymal granulocytic sarcoma in acute lymphoblastic leukemia.
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PMID:Isolated recurrence of intracerebral granulocytic sarcoma in acute lymphoblastic leukemia: a case report. 1664 13

Reversible posterior leukoencephalopathy syndrome (RPLS) is a rare complication of cancer chemotherapy. We have recently observed two cases occurred simultaneously in children receiving different chemotherapy regimens, for hepatoblastoma and acute lymphoblastic leukaemia, respectively. Both children presented with altered mental status, severe visual disturbances, headache, seizures, backpain and hypertension. Magnetic resonance imaging showed cortical and subcortical lesions especially in the occipital and parietal regions, strongly consistent with RPLS. Both patients completely recovered from their neuropsychologic deficits in about ten days only with anticonvulsant and antihypertensive therapy, and chemotherapy regimen was promptly restarted according to the planned protocol, without any neuropsychological sequela. A mild left midriasis was the only neurologic defect that persisted in the patient with acute lymphoblastic leukemia.
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PMID:Reversible posterior leukoencephalopathy syndrome: report of 2 simultaneous cases in children. 1667 45

Reversible posterior leukoencephalopathy syndrome is a clinical-radiological phenomenon associated with headache, vomiting, lethargy, visual disturbances and seizures, concomitant with radiological abnormalities predominantly within posterior cerebral white matter due to cerebral edema. There are multiple triggers as acute hypertension, cancer, hematological disease, renal pathology, red cells transfusions and different drugs. We present two patients with reversible posterior leukoencephalopathy under treatment for acute lymphoblastic leukemia because of the probable association with vinca alkaloids.
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PMID:[Reversible posterior leukoencephalopathy: report of two cases after vincristine treatment]. 1835 42

Alcaligenes xylosoxidans which is an aerobic, non-fermentative gram-negative bacillus found in aqueous environments and human flora, can lead to opportunistic infections. It causes infections in elderly, immunocompromised patients, patients with chronic disorders or premature infants. In this report, a case of A. xylosoxidans bacteremia that developed in a child with acute lymphoblastic leukemia (ALL) was presented. Four-years-old male patient under ALL induction therapy was admitted with symptoms of lethargy, headache, somnolence, and fever (39 degrees C). Cerebrospinal fluid, blood, throat and urine cultures were taken from the patient and empirical treatment with sulbactam cefoperazon and amikacin was initiated. Blood cultures in BacT Alert 3D (Bio Merieux, France) revealed the growth of a gram-negative coccobacillus. The agent which was non-fermentative, indol and H2S negative, was identified as A. xylosoxidans by API 20 NE (Bio Merieux, France). Since fever continued under the current antibiotic treatment, the therapy was switched to imipenem (90 mg/kg 3x/day) and the patient's condition improved markedly after 24 hours. Disc diffusion susceptibility testing of the isolate revealed that it was resistant to ampicillin, cephalothin, cefuroxime, cefoxitin, cefotaxime, amikacin, netilmicin and gentamicin; susceptible to amoxicillin clavulanate, piperacillin tazobactam, seftazidime, cefepime, imipenem and ciprofloxacin. Following 14 days of imipenem therapy, the patient recovered and discharged from the hospital on routine follow-up. It is important to consider A. xylosoxidans as a possible causative agent particularly in the infections that develop in high risk patients at oncology, dialysis and neonatal intensive care units.
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PMID:[Alcaligenes xylosoxidans bacteremia in a patient with acute lymphoblastic leukemia]. 1979 25

Reversible posterior leukoencephalopathy syndrome (RPLS) is recently described disorder with typical radiological findings in the posterior regions of the cerebral hemisphere and cerebellum. Its clinical symptoms include headache, decreased alertness, mental abnormalities, such as confusion, diminished spontaneity of speech, and changed behavior ranging from drowsiness to stupor, seizures, vomiting and abnormalities of visual perception like cortical blindness. RPLS is caused by various heterogeneous factors, the commonest being hypertension, followed by non-hypertensive causes such as eclampsia, renal diseases and immunosuppressive therapy. We presented nine patients with RPLS who had primary diagnoses such as acute post-streptococcal glomerulonephritis, idiopathic hypertension, the performing of intravenous immunoglobulin for infection with crescentic glomerulonephritis, erythrocyte transfusion for severe iron deficiency, L: -asparaginase treatment for acute lymphoblastic leukemia and performing of granulocyte-colony stimulating factor for ulcerative colitis due to neutropenia. Early recognition of RPLS as complication during different diseases and therapy in childhood may facilitate precise diagnosis and appropriate treatment.
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PMID:Reversible posterior leukoencephalopathy syndrome in childhood: report of nine cases and review of the literature. 1980 87

Apolizumab (Hu1D10), a humanized monoclonal anti- Human leukocyte antigen -DR beta-chain antibody, mediates apoptosis of chronic lymphocytic leukemia (CLL) cells in vitro. We conducted a phase I/II dose-escalation study of thrice-weekly apolizumab (1.5, 3.0, 5.0 mg/kg/dose) for 4 weeks in relapsed CLL. Two of six patients at 5.0 mg/kg/dose developed treatment-related dose-limiting toxicity (aseptic meningitis, hemolytic uremia). Other toxicities included infusion toxicity, urticaria, and headache. Eleven patients were enrolled in a phase I/II expansion to evaluate the maximum tolerated dose (MTD) of 3.0 mg/kg/dose. In total, 23 patients were enrolled (22 CLL, 1 ALL). Nineteen patients with CLL were treated at or above the MTD. One partial response was observed, and three patients had stable disease exceeding 6 months. Pharmacokinetic analysis demonstrated a dose-dependent C(max) increase and serum antibody accumulation after week 1 of therapy. Given the toxicity and lack of efficacy in this and other trials in lymphoma and solid tumors, further development of apolizumab was discontinued.
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PMID:A phase I/II dose escalation study of apolizumab (Hu1D10) using a stepped-up dosing schedule in patients with chronic lymphocytic leukemia and acute leukemia. 1988 43

We describe a case of bilateral exudative retinal detachment associated with prodromal symptoms simulating the presentation of acute Vogt-Koyanagi-Harada disease that was eventually diagnosed as acute lymphoblastic leukemia. A 42-year-old man presented with sudden visual loss in both eyes for two weeks. He complained of intermittent headache, neck stiffness and tinnitus for a month. His best-corrected visual acuities were 20/200 in both eyes. Fluorescein angiography, optical coherence topography and indocyanine green angiography featured bilateral serous retinal detachments. A clinical diagnosis of incomplete type Vogt-Koyanagi-Harada disease was considered. However, complete blood cell count showed a marked increase in the number of white blood cells and bone marrow examination revealed precursor B cell lymphoblastic leukemia. The patient started on induction chemotherapy. A week later, his best-corrected visual acuities were 20/25 and the serous retinal detachments were nearly absorbed in both eyes. Bilateral exudative retinal detachment associated with neurologic and auditory abnormalities may be a presenting sign of acute lymphoblastic leukemia. Clinicians should be aware of the possibility of leukemia in such patients.
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PMID:Acute lymphoblastic leukemia manifesting as acute Vogt-Koyanagi-Harada disease. 2004


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